To Study the Role of Ascorbate in Preventing Epistaxis

Abstract

Background: Epistaxis is a common otorhinolaryngological condition that may be associated with nasal mucosal dryness, inflammation, crusting and increased mucosal or vascular fragility. Ascorbic acid (vitamin C) plays an important role in collagen synthesis, connective tissue integrity and vascular health. However, evidence regarding its role in reducing recurrent epistaxis is limited.

Aim: To study the role of oral ascorbate in reducing the severity and frequency of epistaxis.

Materials and Methods: This observational study was conducted in the Department of Otorhinolaryngology at a tertiary care centre in Mangalore over a period of 18 months. A total of 64 patients aged 18–60 years presenting with epistaxis were included using convenience sampling. Patients with blood disorders and procedural bleeding were excluded. Detailed history and ENT examination were performed, and eligible patients were followed up after oral ascorbate treatment. Symptom severity was assessed using Visual Analogue Scale (VAS) scores for bleeding severity, nasal blockage and discomfort. Changes in the frequency of epistaxis episodes were also assessed. Categorical variables were expressed as frequencies and percentages. Pre- and post-treatment VAS scores were compared, with P < 0.05 considered statistically significant.

Results: The mean age of the participants was 33.08 ± 10.77 years (range, 18–55 years), with a male predominance (65.63%). Dry or inflamed nasal mucosa was observed in 67.19% of participants, while crusting was present in 40.63%. Following treatment, the mean VAS score for severity of bleeding episodes decreased from 7.86 ± 0.91 to 2.72 ± 1.21 (t = 23.70, P < 0.001). Nasal blockage severity decreased from 2.63 ± 2.84 to 1.03 ± 1.19 (t = 6.96, P < 0.001), while discomfort due to symptoms decreased from 7.09 ± 1.32 to 1.56 ± 1.30 (t = 21.62, P < 0.001). Furthermore, 56 (87.5%) participants reported a change or reduction in the frequency of epistaxis episodes, whereas 8 (12.5%) reported no change.

Conclusion: Oral ascorbate was associated with significant improvement in bleeding severity, nasal blockage and symptom-related discomfort among patients with epistaxis. A substantial proportion of participants also reported a reduction in the frequency of epistaxis episodes. These findings suggest a potential beneficial role of ascorbate in the management of epistaxis; however, larger controlled studies are required to establish a causal and preventive effect.